GLP-1 use tripled among non-diabetics, reaching $5.8B in 2022

Mounjaro (tirzepatide) is the first GIP and GLP-1 receptor agonist approved by FDA. [Image courtesy of Eli Lilly]

A new analysis reveals GLP-1 use among U.S. adults without diabetes tripled between 2018 and 2022, driving annual spending by this group alone to $5.8 billion by the end of that period. Published in the Annals of Internal Medicine, the Australian study, conducted by researchers at The University of Melbourne, analyzed nationally representative data from the U.S. Medical Expenditure Panel Survey (MEPS) Household Component. The team found that the annual prevalence of GLP-1 receptor agonist (GLP-1 RA) use among nearly 90,000 surveyed adults without diagnosed diabetes jumped from 0.1% between 2018-2021 to 0.4% in 2022. This translates to their precise estimate of 854,728 adults without diabetes using these medications nationwide in 2022, corroborating the press release’s estimate of 800,000 to a million users.

While GLP-1 RA prevalence among non-diabetic adults held steady at 0.1% from 2018-2021, it quadrupled to 0.4% in 2022 alone. This surge pushed annual spending by this group from an average of $1.6 billion between 2018-2021 to $5.8 billion in 2022. During the study period, users filled an average of 4.1 prescriptions, with the mean cost per prescription reaching $1,540. Yet the researchers note that despite the rapid increase, overall adoption remained limited in 2022, with only about one in 250 U.S. adults without diabetes using these drugs.

The rise corresponds with the established effectiveness of GLP-1 RAs, such as semaglutide and liraglutide, for significant weight loss in people with obesity – a group representing roughly 93 million potentially eligible U.S. adults. This study offers the first nationwide picture of GLP-1 RA use and spending specifically among non-diabetic individuals using representative U.S. data, filling a gap left by research focused on diabetic populations or using less comprehensive samples.

This documented $5.8 billion annual expenditure by non-diabetic users underscores significant budgetary implications for the U.S. healthcare system. The findings provide crucial data, according to the researchers, to inform “ongoing discussions about balancing the sustainability of health care spending against improving accessibility and affordability of GLP-1 RA medications moving forward.” The trend directly informs current debates surrounding insurance coverage policies for weight-loss treatments, highlighting the challenge of reconciling costs with clinical demand and benefit.

Beyond their established role in diabetes management and growing use for obesity, the therapeutic horizon for GLP-1 RAs appears to be expanding. Research increasingly points to potential benefits across a spectrum of cardiometabolic and related conditions. Indicative studies include findings suggesting improved survival rates and reduced graft loss for kidney transplant recipients with diabetes using these agents. Furthermore, preliminary data indicates GLP-1 RAs might lower the risk of developing atrial fibrillation in specific heart failure patient populations. These examples underscore the potential for GLP-1 RAs to address a wider range of health challenges in the future. Studies are also underway for a spectrum of other conditions, including Phase 3 trials investigating non-alcoholic steatohepatitis (NASH), chronic kidney disease (CKD), and obstructive sleep apnea (OSA), as well as mid-to-late stage trials exploring potential benefits in neurodegenerative disorders like Parkinson’s disease.